MEDICARE: EYONG BATOU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver

General Provider Information

NPI Number	:	1811534001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EYONG BATOU

Provider Business Mailing Address
First Line	:	6403 SIERRA BLANCA DR APT 1705
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1547
Country	:	US
Telephone Number	:	347-397-5294
Fax Number	:

Provider Business Practice Location Address
First Line	:	6403 SIERRA BLANCA DR APT 1705
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1547
Country	:	US
Telephone Number	:	347-397-5294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2019
Last Update Date	:	12/06/2019

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Directions to “ EYONG BATOU ” Practice Location

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